MEDICARE: CORTEX TBI OF HOUSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1659177061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORTEX TBI OF HOUSTON

Provider Business Mailing Address
First Line	:	1213 HERMANN DR STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7000
Country	:	US
Telephone Number	:	281-677-3516
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 HERMANN DR STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7000
Country	:	US
Telephone Number	:	281-677-3516
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ADAM HAJJI
Credential	:
Telephone Number	:	888-794-4776

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	02/25/2025

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